Betty presents at the ED with chest pain, accompanied by Alan and her daughter Cheryl. On triage, Betty reports that the pain started overnight. Betty is diaphoretic, pale and is complaining of pain - 7/10. She is alert and oriented but needs help to get into the ED from the car via a wheelchair. Once she is moved to a treatment cubicle, a cannula is inserted for IV access and she is given 5mg Morphine IV as a stat does. Her observations are as follows: T: 36.7 , HR:110bpm, BP: 150/90 Sats: 95%RA The admitting ED doctor orders and ECG and Bloods. ECG shows some suggesting a myocardial infarction (MI). Her bloods show raised troponin – also suggestive of a MI. Provisional diagnosis –a second MI and she is admitted to a cardiology ward for a GTN infusion and ongoing monitoring History: Chronic Kidney Disease (CKD) Type 2 diabetes Coronary Artery Disease (CAD), Peripheral Vascular Disease (PVD) Hypertension Myocardial infarction (MI) Height: 168 cm; Weight: 50kg Betty had been in your care for the past few days, she has been very fatigued after her admission to the ward and spent most of the time in bed. Her GTN infusion has now been ceased. She has not complained of any further chest pain. Betty is very keen to return home. You also notice that her legs are swollen, and she is having difficulty moving them when in bed. Betty tells you “My legs are hurting; my body just seems to be letting me down! “You encourage Betty to have her breakfast before her shower, however she only eats a small portion of toast and has a cup of tea. She tells you that she does not have an appetite. Qustion: What are the three interventions and rationales for Betty situation?
Betty presents at the ED with chest pain, accompanied by Alan and her daughter Cheryl. On triage, Betty reports that the pain started overnight. Betty is diaphoretic, pale and is complaining of pain - 7/10. She is alert and oriented but needs help to get into the ED from the car via a wheelchair. Once she is moved to a treatment cubicle, a cannula is inserted for IV access and she is given 5mg Morphine IV as a stat does. Her observations are as follows: T: 36.7 , HR:110bpm, BP: 150/90 Sats: 95%RA The admitting ED doctor orders and ECG and Bloods. ECG shows some <ST elevation> suggesting a myocardial infarction (MI). Her bloods show raised troponin – also suggestive of a MI. Provisional diagnosis –a second MI and she is admitted to a cardiology ward for a GTN infusion and ongoing monitoring History: Chronic Kidney Disease (CKD) Type 2 diabetes Coronary Artery Disease (CAD), Peripheral Vascular Disease (PVD) Hypertension Myocardial infarction (MI) Height: 168 cm; Weight: 50kg Betty had been in your care for the past few days, she has been very fatigued after her admission to the ward and spent most of the time in bed. Her GTN infusion has now been ceased. She has not complained of any further chest pain. Betty is very keen to return home. You also notice that her legs are swollen, and she is having difficulty moving them when in bed. Betty tells you “My legs are hurting; my body just seems to be letting me down! “You encourage Betty to have her breakfast before her shower, however she only eats a small portion of toast and has a cup of tea. She tells you that she does not have an appetite.
Qustion: What are the three interventions and rationales for Betty situation?
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